# Dental timely filing limits by payer (2026)

> What are the dental timely filing limits by payer, and how long do you have to correct or appeal a claim? Read from payer-published documents; honest about every gap.

URL: https://dentovio.com/dental-timely-filing-limits

Last verified: 2026-08-30

Dentovio is an independent publisher — not a payer, the American Dental Association, or any government agency, and it is unaffiliated with the insurers named here. This page was drafted with AI assistance and verified against the primary sources linked here. It has not been reviewed by a credentialed dental billing specialist or attorney. These pages record filing, correction, appeal, records, and recoupment windows as read in each payer's published documents on the last-verified date — and record honestly where no public number exists. Provider contracts override published manuals, editions change, and several payers set different rules per state, network, or program. Educational reference only, not billing or legal advice; confirm the controlling number in your participation contract and the payer's current provider manual before relying on it.

## Direct answer

There is no single dental timely-filing limit — each payer sets its own, and several publish none at all. Verified against payer-published documents: Cigna allows 90 days participating / 180 out-of-network; Delta Dental's deltadentalins.com enterprise generally denies claims received more than 12 months after treatment; Humana allows 15 months on most fully insured commercial products and 12 months for Medicare claims; UnitedHealthcare's state Medicaid dental manuals run 90 (WI), 180 (NE), and 120 (NY) days; MCNA Texas runs 95 days and Molina Kentucky 365; Medicaid fee-for-service carries a federal 12-month rule (42 CFR 447.45(d)(1)) and Medicare a 1-calendar-year rule (42 CFR 424.44(a)(1)). United Concordia and MetLife publish no public numbers — their guides are login-gated. Provider contracts override published manuals, so the contract number controls.

## Master table (payer-published windows)

| Payer | Initial filing | Corrected claims | First appeal | Where published |
| --- | --- | --- | --- | --- |
| [Ameritas](https://dentovio.com/dental-timely-filing-limits/ameritas/index.html.md) | 90 days | Not extracted | No level extracted | Published openly |
| [Cigna](https://dentovio.com/dental-timely-filing-limits/cigna/index.html.md) | 90 days | No public number | 180 days | Published openly |
| [Delta Dental](https://dentovio.com/dental-timely-filing-limits/delta-dental/index.html.md) | 12 months | Not extracted | No public number | Published openly |
| [Guardian](https://dentovio.com/dental-timely-filing-limits/guardian/index.html.md) | No public number | Not extracted | No public number | No public statement found |
| [Humana](https://dentovio.com/dental-timely-filing-limits/humana/index.html.md) | Varies | No public number | No public number | Published openly |
| [MetLife](https://dentovio.com/dental-timely-filing-limits/metlife/index.html.md) | No public number | Not extracted | No level extracted | No public statement found |
| [Sun Life](https://dentovio.com/dental-timely-filing-limits/sun-life/index.html.md) | No public number | Not extracted | No public number | Behind provider login |
| [United Concordia](https://dentovio.com/dental-timely-filing-limits/united-concordia/index.html.md) | No public number | No public number | No public number | Behind provider login |
| [UnitedHealthcare (NE Medicaid)](https://dentovio.com/dental-timely-filing-limits/unitedhealthcare-nebraska/index.html.md) | 180 days | Not extracted | 60 days | Published openly |
| [UnitedHealthcare (NY Medicaid)](https://dentovio.com/dental-timely-filing-limits/unitedhealthcare-new-york/index.html.md) | 120 days | Not extracted | 60 days | Published openly |
| [UnitedHealthcare (WI Medicaid)](https://dentovio.com/dental-timely-filing-limits/unitedhealthcare-wisconsin/index.html.md) | 90 days | 365 days | 90 days | Published openly |
| [AmeriHealth Caritas (LA Medicaid)](https://dentovio.com/dental-timely-filing-limits/amerihealth-caritas-louisiana/index.html.md) | 365 days | 180 days | 180 days | Published openly |
| [MassHealth (DentaQuest)](https://dentovio.com/dental-timely-filing-limits/dentaquest-masshealth/index.html.md) | 90 days | 12 months | 30 days | Published openly |
| [SC Medicaid (DentaQuest)](https://dentovio.com/dental-timely-filing-limits/dentaquest-south-carolina/index.html.md) | 12 months | Not extracted | 30 days | Published openly |
| [MCNA (AR Medicaid)](https://dentovio.com/dental-timely-filing-limits/mcna-arkansas/index.html.md) | 365 days | Not extracted | 90 days | Published openly |
| [MCNA (TX Medicaid/CHIP)](https://dentovio.com/dental-timely-filing-limits/mcna-texas/index.html.md) | 95 days | 365 days | 120 days | Published openly |
| [Molina (KY Medicaid)](https://dentovio.com/dental-timely-filing-limits/molina-kentucky/index.html.md) | 365 days | 365 days | 60 days | Published openly |
| [Original Medicare](https://dentovio.com/dental-timely-filing-limits/medicare/index.html.md) | 12 months | Not extracted | No level extracted | Published openly |
| [Medicaid FFS (federal rule)](https://dentovio.com/dental-timely-filing-limits/medicaid/index.html.md) | 12 months | Not extracted | No level extracted | Published openly |

"Not extracted" means this pass did not verify a window — not that none exists. A payer's absence from this table means "not verified yet," not "no rule exists."

## Verified cross-payer facts

### A rejected claim never paused the clock

Rejected and returned-as-unprocessable claims “will not be considered filed for purposes of determining timely filing” — the corrected claim must be accepted before the original deadline. A denied claim is different: it was filed, and it is appealable. Under most commercial contracts a clearinghouse acceptance report can support a timely-filing appeal; a rejection report cannot, because nothing was accepted.

- [CMS Medicare Claims Processing Manual, Pub. 100-04, Ch. 1](https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c01.pdf)
- [First Coast Service Options — returned/rejected claims and timely filing (2026-02-17)](https://medicare.fcso.com/claims/returned-or-rejected-unprocessable-claims-affect-timely-filing)

### Recoupment look-back caps are state law — and they vary widely

Where a cap exists it is statutory, and the spread is wide: Maryland bars carriers from retroactively denying reimbursement more than 6 months after payment (18 months for coordination-of-benefits claims); New York bars overpayment recovery efforts more than 24 months after the original payment. Both carve out fraud and improper billing. There is no national norm — check your state's statute before accepting a look-back.

- [Md. Code, Insurance § 15-1008 (Maryland General Assembly)](https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin&section=15-1008&enactments=false)
- [NY Insurance Law § 3224-b (NY Senate)](https://www.nysenate.gov/legislation/laws/ISC/3224-B)

### The COVID filing relief is over — and it never covered provider timely filing

The federal deadline tolling ended when the Outbreak Period closed on July 10, 2023 — tied to the COVID-19 National Emergency, not the public-health emergency — and it tolled member claim- and appeal-filing deadlines under ERISA and Code plans, never provider filing windows. Any commercial-payer COVID exception was payer-by-payer and is not assumed here.

- [DOL/HHS/Treasury FAQs About Coronavirus and Health Coverage, Part 58 (Mar. 29, 2023)](https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-58)

## Related

- [Dental claim denial codes](https://dentovio.com/dental-claim-denial-codes/index.html.md)
- [Payer documentation requirements](https://dentovio.com/dental-claim-documentation/index.html.md)
- [Dental prompt-pay laws by state](https://dentovio.com/dental-prompt-pay-laws/index.html.md)
- [Dental billing & claims hub](https://dentovio.com/dental-billing/index.html.md)